Individual
JAIME A LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6407 SOUTHWEST BLVD, BENBROOK, TX 76132-2777
(817) 423-5611
Mailing address
648 JACIE CT, BURLESON, TX 76028-1324
(817) 682-3565
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216154
TX
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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